Gerlant Van Berlaer poses at the University Hospital UZ in Brussels. Van Berlaer, a prominent Brussels pediatrician, says teenage boys and girls who are in the advanced stages of cancer or other terminal illnesses, should be able to ask to be euthanized.

Belgium, one of the very few countries where euthanasia is legal, is expected to take the unprecedented step this week of abolishing age restrictions on who can ask to be put to death — extending the right to children.

The legislation appears to have wide support in the largely liberal country. But it has also aroused intense opposition from foes — including a list of pediatricians — and everyday people who have staged noisy street protests, fearing that vulnerable children will be talked into making a final, irreversible choice.

Backers like Dr. Gerland van Berlaer, a prominent Brussels pediatrician, believe it is the merciful thing to do. The law will be specific enough that it will only apply to the handful of teenage boys and girls who are in advanced stages of cancer or other terminal illnesses and suffering unbearable pain, he said.

Under current law, they must let nature take its course or wait until they turn 18 and can ask to be euthanized.

“We are talking about children that are really at the end of their life. It’s not that they have months or years to go. Their life will end anyway,” said Van Berlaer, chief of clinic in the pediatric critical care unit of University Hospital Brussels. “The question they ask us is: ‘Don’t make me go in a terrible, horrifying way, let me go now while I am still a human being and while I still have my dignity.’”

The Netherlands already allows euthanasia for children as young as 12, providing their families agree.

The Belgian Senate voted 50-17 on Dec. 12 to amend the country’s 2002 law on euthanasia so that it would apply to minors, but only under certain additional conditions. Those include parental consent and a requirement that any minor desiring euthanasia demonstrate a “capacity for discernment” to a psychiatrist and psychologist.

The House of Representatives, the other chamber of Parliament, is scheduled to debate on Wednesday whether to agree to the changes, and vote on them Thursday. Passage is widely expected.

King Philippe, Belgium’s constitutional head of state, must sign the legislation for it to go into effect. So far, the 53-year-old monarch and father of four has not taken a public position, but spokesman Pierre De Bauw said that is not unusual. “We never give any comment on any piece of legislation being discussed in Parliament,” De Bauw said Tuesday.

Though one opinion poll found 75 percent of Belgians in favor, there has been a vocal opposition.

This week, an “open letter” carrying the names of 160 Belgian pediatricians was issued to argue against the new law, claiming there is no urgent need for it and that modern medicine is capable of soothing the pain of even the sickest children.

Van Berlaer, 45, was not one of the signatories. Very sick children who are surrounded by other ill and dying people are not like other youngsters, and mature quickly_too quickly, he said. They may look on as friends or neighbors in their ward die because they can no longer breathe or swallow, and come to realize what lies ahead for them.

In such cases, Van Berlaer said, a child may want to say goodbye to classmates and family, and ask if he or she can stop living.

“The thing is that it is an ultimate act of humanity and even love for the patients, minors in this case, that we at least listen to this question and think about why they would ask such a difficult thing,” Van Berlaer said. “And it will never be easy, even if the law changes now, things won’t be easier.”

Besides Belgium, the only other countries to have legalized euthanasia are two of its neighbors, the Netherlands and Luxembourg, said Kenneth Chambaere, a sociologist and member of the End-of-Life Care research group at the Free University Brussels and University of Ghent.

In the Netherlands, children between 12 and 15 may be euthanized with parents’ permission, while those who are 16 or 17 must notify their parents beforehand. Luxembourg limits the practice to legal adults 18 and older.

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